Thank you for the work you are doing in Haiti.
We wanted to bring your attention to the use of unpasteurized honey as a resource for wound care that would be valuable in the less than ideal conditions of medical supply and care in Haiti. Should you wish to adopt it, we will arrange for supply of honey packed in 15 or 30 kg pails from Canada.
We gather from TV coverage that wound infection is a major concern for lack of materials to care for them. We can also can guess that aftercare is a problem. Regular bandage care with surgical debridement and lavage are often required post-op. A medic’s good work can go for naught without it. Oral or injectable antibiotics may not effectively reach the site of infection when circulation at the wound site is compromised. This is often the case in crushing injuries and deep gashes.
Honey has been regarded as an effective wound dressing for centuries. This has been examined objectively and case studies reported in peer reviewed journals, a sampling of which are available on this page, provided by Dr. Karol Mathews of the Ontario Veterinary College in Guelph, Canada. They document value in treating large area wounds in dogs and cases of gangrene and paediatric burns in humans, as well as a review published in by the Journal of the Royal Society of Medicine.
Honey is an effective primary dressing. Honey dressings may help to overcome a lack of medically supervised aftercare if it is an issue. A thick layer of honey is a physical barrier to contamination, and is thus a readily available and inexpensive dressing at triage, if primary care will be delayed.
Using only honey and regular dressing changes, suppurative and recalcitrant wounds debride well, infection clears and a beautiful bed of granulation tissue forms. Topical application of honey will remove bacteria lodged in subcutaneous pockets and it will flow anywhere there is a space and remove contaminating material and bacteria. It reduces inflammatory edema, and acts a wound healing accelerant.
Bandage changes must be at least daily for the first few days, after which every 48 hours may suffice. A dry dressing covering the honey is required. Sterile and disposable dressings would be preferred, but cloth towels can be used. These can cleaned with soap if available and then boiled in water, air dried and re-applied. If a patient is to manage their own care after discharge, they of course should return frequently for assessment. A final thorough rinse/lavage must be with sterile saline prior to any surgical closure.
There may be a concern regarding potential botulinum spores in raw honey. Neither botulism (even in little children when applied to wounds), nor sugar accessing the blood stream causing hyperglycemia have been reported in the medical literature with respect to the use of honey in wound management.
We opine that:
1) Unpasteurized honey is an inexpensive and viable primary therapy or adjunct for managing the types of wounds as have inflicted casualties in Haiti.
2) Dressings might be competently managed, with appropriate medical supervision, by the patients themselves after initial post op assessment, freeing up medics for other work.
3) There may be more patient treatments per aid or transport dollar available vs costly medications and dressings, which could be reserved for other cases.
If there is a need for treatment adjuncts or alternatives, and if honey dressings would be accepted as a viable and documented therapy, we will get it there. But note it need not be our honey, we are just as interested that the information get to those who may need it. Local unpasteurized honey may work as well, if available, provided it is clean and not fermented.
For additional information, please contact us. We would regret that a viable therapy be put aside for want of understanding.
Dr. Karol Mathews, Ontario Veterinary College email@example.com – clinical practice and research
Dr. Greg Hawkins, CentaurVA Animal Health / Hawkins Honey and Maple Co, firstname.lastname@example.org, Skype greg.hawkins1 - supply
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